‘Nearly ten million stroke deaths by 2050’ – warning

The number of people who die from stroke globally could rise by 50% by 2050, according to report from the World Health Organization published today.

The report, a WHO-Lancet Neurology Commission, warns annual costs could grow to US$2.3 trillion if no urgent action is taken to reduce the burden of stroke. Worse affected will be low-to-middle-income countries (LMICs).

The number of deaths annually could reach 9.7 million, the report says.

The authors have made 12 recommendations to reduce the global burden, including measures to improve stroke surveillance, prevention, acute care, and rehabilitation.

The number of people who suffer a stroke has almost doubled over the past 30 years, with most in LMICs, where prevalence is increasing at a faster rate than in high-income countries.

WHO warns if the current trends continue, one of its key Sustainable Development Goals (SDGs) – o reduce the 41 million premature deaths from non-communicable diseases – including stroke – by one third by 2030 – will not be met.

Among its key recommendations are: establishing low-cost surveillance systems to provide accurate epidemiological stroke data to guide prevention and treatment; raising public awareness to improve healthy lifestyles and prevent; and prioritising effective planning of acute stroke care services.

The authors used the Global Burden of Disease (GBD) study methods to provide estimates of stroke burden between 2020 and 2050 in HICs, LMICs and by major GBD world regions and age. They estimate the number of people who die annually from stroke globally will increase by 50%, rising from 6.6 million in 2020 to 9.7 million in 2050.

The number of stroke deaths in LMICs is projected to rise sharply from 5.7 million in 2020 to 8.8 million in 2050. In contrast, stroke deaths in HICs are estimated to remain largely unchanged at about 900,000 between 2020 and 2050. This means the proportion of global stroke deaths in LMICs will increase from 86% in 2020 to 91% in 2050.

While the global death rate among people aged over 60 years is predicted to fall by 36%, from 566 deaths per 100,000 in 2020 to 362 per 100,000 in 2050, it will fall by less than 25% in under-60s, from 13 per 100,000 in 2020 to 10 per 100,000 in 2050 because of the prevalence of diabetes.

Professor Valery Feigin, of Auckland University of Technology, New Zealand, and Commission co-chair, said: “One of the most common problems in implementing stroke prevention and care recommendations is the lack of funding.

“Our Commission recommends introducing legislative regulations and taxations of unhealthy products (such as salt, alcohol, sugary drinks, trans-fats) by each and every government in the world. Such taxation would not only reduce consumption of these products – and therefore lead to the reduction of burden from stroke and major other non-communicable diseases – but also generate a large revenue sufficient to fund not only prevention programmes and services for stroke and other major disorders, but also reduce poverty, inequality in health service provision, and improve wellbeing of the population.”

Professor Mayowa Owolabi, of the University of Ibadan, Nigeria, and Commission co-chair added: “Investing in evidence-based measures to reduce the global burden of stroke will deliver benefits that go far beyond health alone. As well as delivering health and economic benefits relating to stroke, many of our recommendations would also facilitate reductions in poverty and inequality and boost local economies.”

Feigin VL, Owolabi MO. Pragmatic solutions to reduce the global burden of stroke: a World Stroke Organization–Lancet Neurology Commission. Lancet 10 October 2023

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